Kornimate/medical-research-clean huggingface dataset:
recruitment maneuver using lung ultrasound in trauma patients

Conditions: Recruitment; Trauma

Summary: in trauma patients, the incidence of pulmonary contusion is frequent. recruit maneuver using lung ultrasound could be improve oxygenation in trauma populatioin, howevere, there is no previous study. the aim of this study is evaluation of the efficacy of lung recruitment using ultrasound in perioperative period in trauma patients.

in trauma patients, the incidence of pulmonary contusion is 17-75%. pulmonary contusioin leads to atelectasis, lung consolidatioin. finally it could results acute respiratory distress syndrome. lung ultrasound is non-invasive and available in anytime even during surgery. previous studies showed recruitment maneuver using ultrasound improved postoperative oxygenation in pediatric cardiac surgery. in adults, recruitment maneuver not using ultrasound improved oxygenation after cardiopulmonary bypass. there is no study in adult trauma population. the aim of this study is evaluation of the efficacy of lung recruitment using ultrasound in perioperative period in trauma patients.

Eligibility criteria:
inclusion criteria: * who need surgery under general anesthesia due to trauma * the position of the surgery is supine exclusion criteria: * who has been ventilator care before the surgery * thoracic surgery * who had cardiopulmonary resuscitation * who has acute respiratory distress syndrome

Keywords: recruitment ultrasound trauma pulmonary contusion
western kenya integrated covid-19 response

Conditions: Covid19

Summary: to respond to the covid-19 pandemic, investigators will be deploying community health workers, equipped with mobile technology, and accompanied by youth to visit households door to door to screen for symptoms of covid-19, isolate, test, and manage suspected cases of covid-19. the community health workers and youth will educate households about preventive measures including frequent handwashing and home management of mild cases. simultaneously, investigators will work with nurses, doctors, and clinical officers, to test and treat more severe cases of covid-19 in health facilities. our goals are: to visit every household in siaya county covering a population of close to 1 million, and to train and support health workers working in 32 health facilities with oxygen capacity in siaya to reduce the morbidity and mortality related to covid19 and other conditions.


Eligibility criteria:
inclusion criteria: * youth aged 18 to 30 years old. * active community health workers. * facilities with oxygen capacity. exclusion criteria: * individuals younger than 18 or older than 30 years old. * inactive community health workers. * facilities without oxygen capacity.

Keywords: youth, community health, digital tools, capacity building
local intraoperative analgesic injection versus single injection interscalene nerve block in patients undergoing tsa

Conditions: Osteoarthritis: Shoulder

Summary: a non-blinded randomized controlled trial, in which participants undergoing primary reverse or total shoulder arthroplasty are randomly assigned to one of two treatment groups.


Eligibility criteria:
inclusion criteria: 1. all individuals undergoing primary reverse and total shoulder arthroplasty by the shoulder service at methodist hospital or rothman specialty hospital. exclusion criteria: 1. psychiatric illness as defined by co-morbid diagnosis of bipolar disorder or schizophrenia 2. revision arthroplasty, arthroplasty for fracture 3. unable/unwilling to consent for enrollment 4. unable to complete postoperative pain survey 5. known adverse drug reaction or allergy to the medications used 6. chronic pain syndromes (including reflex sympathetic dystrophy, fibromyalgia, chronic diffuse musculoskeletal pain) 7. patients taking long acting narcotic pain medications (including extended release narcotic pain medications and methadone). 8. patients under the age of 18 years 9. patients with history of hepatic disease 10. pregnant women or women who are breastfeeding
neuromodulation of inflammation and vascular function in systolic heart failure

Conditions: Heart Failure With Reduced Ejection Fraction

Summary: heart failure (hf) is the leading cause of death in us. it is associated with abnormal vascular function termed endothelial dysfunction. it is also associated with increased stress on the blood vessels and high levels of inflammation. vagus nerve stimulation can help improve inflammation, vascular function and vascular stress. the investigator has recently completed a study showing that 1 hour of noninvasive vagus stimulation can improve vascular health. however, it is unknown if 4 weeks of stimulation will be beneficial in systolic heart failure. the purpose of this study is to determine if transcutaneous vagal stimulation (tvs) will lead to improvement in the function of the inner lining of participants' arteries, memory, and in the levels of certain chemical markers of arterial function in the blood. participants will be randomized to receive either tvs or a sham stimulation and undergo 4 weeks of stimulation. vascular function will be assessed by several non-invasive measurements, including flow mediate dilation (fmd), pulse wave analysis (pwa), endopat, and laser speckle contrast imaging (lsci). participants' memory will also be measured through electronic assessments and blood will be collected and analyzed for arterial function chemical markers.

visit 1: following tests(to assess vascular function) will be done: 1. fmd 2) lsci 3) endopat and 4) pulse wave analysis (pwa). patients will rest for 10 minutes between each test. they will be trained to use parasymtm unit for tvs. blood collected, serum/plasma will be stored at -80f. whole blood will be collected in paxgene tubes. patients will be instructed to apply tvs to either ear lobule (sham) or tragus(experimental arm). baseline characteristics will be collected including data on ventricular function(lvef and left ventricular volumes). visit 2 (4 weeks): follow up tests(fmd,lsci,endopat,pwa) and repeat blood collection. inflammatory cytokines and vascular function assays will be performed.

Eligibility criteria:
inclusion criteria: 1. patients (18 years or older) with heart failure with reduced ejection fraction (hfref), which is a history of symptomatic heart failure with left ventricular ejection fraction (lvef) of \< 40%. exclusion criteria: 1. patients in overt congestive heart failure / recent acute myocardial infarction (\< 3 months) or unstable angina 2. active malignancy 3. pre-menopausal women and post-menopausal women on hormone supplements. 4. unilateral or bilateral vagotomy 5. patients with bilateral upper extremity amputation 6. pregnant patients 7. end-stage renal disease 8. end-stage liver disease 9. history of recurrent vasovagal syncope, sick sinus syndrome, 2nd- or 3rd-degree atrioventricular (av) block. 10. patients with clinically documented upper extremity arterial disease 11. patients with a body mass index (bmi) \>35 12. significant hypotension (blood pressure \<90mmhg) secondary to autonomic dysfunction
a clinical study carried out in patients operated with calcanail®

Conditions: Calcaneus Fracture; Calcaneus Deformity of Foot; Arthrosis; Localized

Summary: this study is part of the post-market clinical follow-up process for the calcanail medical device; the objective of which is to collect data on the safety and performance of the device after it has been placed on the market. the primary objective of this study is to evaluate the safety of the device. the secondary objectives are to evaluate the clinical performance and safety of the device. this is a research not involving the human person: observational study, retrospective, monocentric, non-comparative and national. 84 patients will be included in the study.

the calcanail nail is an osteosynthesis nail intended for the repair of articular fractures of the calcaneus, deformities of the hindfoot and arthrosis of the hindfoot. this study aims to answer specific questions about the clinical performance, efficacy or safety of the medical device when used in accordance with its instructions for use. it will also enable us to better detect rare adverse events if necessary, as well as medium-term results.

Eligibility criteria:
inclusion criteria: 1. patient operated with the studied device between the 01/01/2012 and 01/01/2020. 2. patient over 18 years old 3. patient who has received informed information and does not object to the collection of their data in this study. exclusion criteria: patient refusing the use of his data or deceased patient who expressed in writing during his lifetime the non-use of his medical information.
motivational interviewing and neuroimaging with adolescents

Conditions: Alcohol Use, Unspecified

Summary: this is a randomized controlled trial to examine the impact of two brief interventions on adolescent and young adult alcohol use behaviors and related brain response. the interventions being compared are motivational interviewing (mi) and brief adolescent mindfulness (bam).


Eligibility criteria:
inclusion criteria: * within the specified age range * \>= 1 past two month binge drinking episode * right-handed * proficient in english * agree to be contacted for the 3, 6, and 12 month follow ups * informed consent of a parent/guardian, if under 18 years old * informed assent/consent of participating youth exclusion criteria: * \> 3 past-month instances of non-nicotine and/or non-cannabis substance use (e.g., methamphetamine) * evidence of brain injury/illness or neurological disorder including psychosis * lifetime loss of consciousness \>= 2 min * unremovable metal on/in body, or other functional magnetic resonance imaging (fmri) contraindications (e.g., pregnancy)
comparison of laparoscopic pectopexy and laparoscopic lateral suspension techniques in uterine-preserving apical prolapsus repair

Conditions: Pelvic Organ Prolapse

Summary: the aim of the study will be to compare the laparoscopic pectopexy (lp) and laparoscopic lateral suspension (lls) techniques in the management of uterine sparing apical prolapse (pop-q \>2) at 1 year and yearly up to 2 years.

primary and secondary endpoints: primary outcome measures will be the subjective cure of prolapse ("absence or presence of a bulge in the vagina"), objective success with anatomic absence of advanced prolapse at pop-q sites ba, c and bp defined as less than 1 cm individually and as a total. secondary outcome measures include all other parameters such as perioperative outcomes, patient satisfaction, quality of life outcomes, complications, scores on questionnaires, and reoperations. the study protocol will be submitted to the institutional review boards of every participating study site and written informed consent will be obtained from all participants on enrolment. project design: the investigators will perform an international multicentre single-blind randomized controlled trial with participating our tertiary referral hospital.

Eligibility criteria:
inclusion criteria: * women with symptomatic stage 2 or greater (point c -1 or more pelvic organ prolapse quantification pop-q) apical prolapse exclusion criteria: * women not eligible for surgery for medical or anesthesiological reasons * inability to comprehend questionnaires * inability to give informed consent * inability to return for a review * prior laparoscopic prolapse repair * prior vaginal mesh prolapse procedure * severe cardiovascular or respiratory disease * women who don't want uterine preserving surgery * pregnancy * age \ 45 years

Keywords: pectopexy lateral suspension pelvic organ prolapse uterine sparing laparoscopy
monoclonal antibody 3f8 and sargramostim in treating patients with neuroblastoma

Conditions: Neuroblastoma

Summary: rationale: monoclonal antibodies, such as monoclonal antibody 3f8, can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. colony-stimulating factors, such as sargramostim, may increase the number of immune cells found in bone marrow or peripheral blood. combining monoclonal antibody 3f8 with sargramostim may cause a stronger immune response and kill more tumor cells. purpose: phase ii trial to study the effectiveness of combining monoclonal antibody 3f8 with sargramostim in treating patients who have neuroblastoma.

objectives: * determine the efficacy of sargramostim (gm-csf) in enhancing monoclonal antibody 3f8-mediated ablation in patients with high-risk neuroblastoma. * determine the prognostic impact of minimal residual bone marrow disease on relapse-free survival of patients treated with this regimen. * compare the effects of short-term (2-hour intravenous) vs prolonged (subcutaneous release) daily gm-csf on granulocyte activation, in order to establish the optimal route for tumor-cell kill in these patients. outline: this is an open-label study. patients are stratified according to evaluable disease (yes \[primary refractory bone marrow disease\] vs no \[no evidence of disease\]). patients receive sargramostim (gm-csf) subcutaneously on days -5 to 4 and monoclonal antibody 3f8 iv over 0.5-1.5 hours on days 0-4. treatment repeats every 3 weeks for 4 courses and then every 8 weeks for up to a total of 24 months in the absence of disease progression or unacceptable toxicity. beginning after 2 courses of gm-csf and monoclonal antibody 3f8, patients also receive oral isotretinoin twice daily on days 1-14 (when no monoclonal antibody 3f8 is administered). treatment with isotretinoin repeats approximately every 28 days for 6 courses. projected accrual: a total of 340 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosis of neuroblastoma by histopathology or bone marrow metastases and high urine catecholamine levels * disease must meet risk-related treatment guidelines and any of the following international neuroblastoma staging system stages: * stage 4 with (any age) or without (\> 18 months of age of age) mycn amplification * mycn-amplified other than stage 1 * no evidence of disease (i.e., in complete response/remission or very good partial response/remission) or disease resistant to standard therapy (i.e., incomplete response in bone marrow) * no progressive disease or mibg-avid soft tissue tumor patient characteristics: * no existing renal, cardiac, hepatic, neurologic, pulmonary, or gastrointestinal toxicity ≥ grade 3 * no human anti-mouse antibody (hama) titer greater than 1,000 elisa units/ml * no history of allergy to mouse proteins * no active life-threatening infection * not pregnant * negative pregnancy test prior concurrent therapy: * not specified

Keywords: disseminated neuroblastoma localized unresectable neuroblastoma recurrent neuroblastoma regional neuroblastoma stage 4s neuroblastoma
pilates exercises in spanish women with fibromyalgia

Conditions: Fall Due to Loss of Equilibrium

Summary: to analyze the effects of a pilates exercise program in spanish postmenopausal women with fibromyalgia

this is a randomized clinical trial of single-blind with 2 arms (control group and experimental group), in which a pre-treatment-postest design has been used. the study will define two groups: * a control group (cg) that will not be submitted to treatment, which will be evaluated in the pre and post phase of the study. participants assigned to this group will receive general advice on the positive effects of regular physical activity and will be given a guide to recommendations for promoting physical activity. * an experimental group (ge) that after an initial evaluation will undergo a physical training program based on pilates exercises. once the intervention is finished, it will be submitted to a final evaluation to see if there is a difference or not with the results obtained at the beginning.

Eligibility criteria:
inclusion criteria: * no menstrual activity for at least 12 months. * present fibromyalgia. * do not participate in a weight loss program. * be able to understand the instructions, programs and protocols of this project. exclusion criteria: * contraindications for conducting physical tests. * diseases that limit the static and dynamic balance and physical activity. - * central or peripheral vestibular or nerve alterations.
prospective observation of the fluoroscopy-guided cervical epidural approach using the contralateral oblique view

Conditions: Cervical Intervertebral Disc Disease; Cervical Spinal Stenosis; Cervical Radicular Pain; Herpes Zoster; Postherpetic Neuralgia

Summary: the aim of the present study is to investigate the safety and clinical utility of contralateral oblique view for fluoroscopic guided cervical epidural access.

a cervical epidural block is a widely used intervention to reduce pain in patients with cervicalgia or cervical radicular pain. to achieve a successful procedure, accurate access to the cervical epidural space is needed. however, careful attention is required for this cervical epidural procedure due to a possibility of serious complications such as spinal cord infarction and quadriplegia due to blood vessel damage, convulsion due to an intravascular drug administration, cerebral infarction due to vascular embolism, subdural or subarachnoid injection, hematoma, and spinal cord injury. although the use of fluoroscopy improves the safety and accuracy of cervical epidural access, this technique still has significant drawbacks, such as false loss of resistance and difficulty in assessing the depth of the needle tip in lateral views in relation to the epidural space. to overcome this issue, cervical epidural access using the contralateral oblique (clo) view has been introduced and the ideal angle of clo view for the cervical spine is reported as 50 degrees. however, it has not been reported on the safety and clinical utility of using the clo view during cervical epidural access. therefore, the investigators planned this study to observe the safety and clinical utility of the clo view at 50 degrees for the cervical epidural block.

Eligibility criteria:
inclusion criteria: * patients who need an epidural space access at c6-7 or c7-t1 level * patients who are expected to undergo cervical epidural block * patients who are expected to undergo cervical epidural neuroplasty * 20 ≤ age \<80 * when obtaining informed consent voluntarily exclusion criteria: * allergy to local anesthetics and contrast dye, and steroid * use of anticoagulants or antiplatelet medication, coagulopathy * infection at the insertion site * neurological or psychiatric disorders * prior spine instrumentation * pregnancy * not visible epidural space due to severe cervical spinal canal stenosis

Keywords: fluoroscopy contralateral oblique view cervical epidural block cervical epidural space
palliative care protocol for adult patients hospitalized in critical care units.

Conditions: End of Life Care; Critical Illness; Palliative Care

Summary: the goal of this clinical trial is to determine the effectiveness of a palliative care protocol in improving the quality of care of adult patients at high risk of dying hospitalized in the critical care unit. assessing symptom burden (dyspnea, pain and/or anxiety/agitation) until death or day 5 (whichever comes first) researchers will compare the impact of the palliative care protocol with standard care to see if it improves the quality of care. participants will: 1. symptom management. 2. respect for the autonomy of the patient and his/her family environment. 3. respectful management of clinical information. 4. provision of holistic care and support.

we designed a stepped wedge cluster randomized trial the study is implementation in 5 chilean hospitals, admitting 248 patients. pre-intervention (control): the practices of each icu will be maintained, until the moment that according to randomization corresponds the beginning of the intervention, in each center. post-intervention: palliative care protocol to improve the quality of care

Eligibility criteria:
inclusion criteria: * 18 years old and older * hospitalization in critical care unit for more than 48 hrs. * medical indication of therapeutic effort limitation, defined as: a) non-initiation or withdrawal of life support therapies: invasive mechanical ventilation, vasoactive drugs, cardiopulmonary resuscitation, renal replacement therapy. exclusion criteria: * severe communication disorder and cultural language limitation (language other than spanish). * absence of legal representative and/or caregiver. * brain dead patient.
a prospective cohort of displaced adolescent midshaft clavicle fractures

Conditions: Malunion of Fracture of Clavicle; Delayed Union of Fracture of Clavicle

Summary: outcomes for displaced midshaft clavicle fractures in adolescents are not defined. the current method of treatment for these fractures is non-operative management. there is recent level 1 evidence in the adult literature to suggest that outcomes are superior when these fractures are managed surgically with open reduction and internal fixation.

the study is a prospective observational cohort design of the natural history of adolescent clavicle fractures treated at the mcgill university health centre. surgeon choice will dictate treatment. there is no difference from the current normal therapy choice of each individual surgeon. patients will be offered either operative or conservative management. operative treatment: patients with displaced midshaft clavicle fractures will be offered operative treatment which involves open reduction and internal fixation with a plate. this is the standard treatment for completely displaced fractures in the adult population at our institution based on level 1 evidence. conservative care: patients will be treated in a sling for the acute phase of two weeks with progressive physiotherapy.

Eligibility criteria:
inclusion criteria: * age 12-18 years old * the only fracture present in that upper extremity * individual and/or parents able to comply with follow-up exclusion criteria: * head injury * prior injury, degenerative condition or congenital condition of the upper extremities * systemic disease that may impair healing * incapable of ensuring follow-up

Keywords: prospective adolescent displaced clavicle fracture mid-shaft
a study to investigate the time to onset of action of 10 mg and 20 mg of vardenafil compared to placebo in males with erectile dysfunction

Conditions: Erectile Dysfunction

Summary: this purpose of the study was to evaluate the earliest time to onset of action in adults with erectile dysfunction (often called impotence). in this study vardenafil has been compared to placebo. patients were asked to fill in questionnaires and a diary in which they filled in details about attempts at sexual activity during study period. patients received also a stopwatch to record the time of onset of erection. stopwatch should be started immediately prior to initiating sexual activity and stopped when an erection perceived to be adequate for penetration was obtained.


Eligibility criteria:
inclusion criteria: * males with ed for more than 6 months according to the nih consensus statement(inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance) * heterosexual relationship * 18 years and older exclusion criteria: * primary hypoactive sexual desire * history of myocardial infarction, stroke or life threatening arrhythmia within the prior 6 months * nitrates or nitric oxide donors use * other exclusion criteria according to the us product information

Keywords: erectile dysfunction vardenafil onset of action